Symptoms of HIV vary widely depending on the infection stage, immune response, and whether treatment has started. Understanding the symptoms of HIV helps with early detection, timely diagnosis, and knowing when to seek medical care. HIV symptoms often mimic common illnesses or remain silent for years, which contributes to underdiagnosis.
Phases and Symptoms of HIV
HIV progresses through three main stages, each with different symptoms:
- Acute HIV infection
- Chronic (clinical latency) stage
- Advanced HIV infection (AIDS)
Not everyone experiences all symptoms, and some people may have no noticeable signs until the virus is advanced.
Acute HIV Infection (Primary Stage)
Within 2 to 4 weeks after exposure, many people develop acute retroviral syndrome, a flu-like illness that lasts days to weeks. Early symptoms include:
- Fever
- Sore throat
- Swollen lymph nodes
- Rash (non-itchy, flat, widespread)
- Fatigue
- Muscle and joint pain
- Headache
- Night sweats
- Mouth ulcers
This stage is highly infectious due to a high viral load but is often mistaken for a cold or flu.
Chronic HIV Infection (Clinical Latency Stage)
Following the acute phase, HIV enters a clinical latency period where symptoms may be absent or mild. The virus continues to replicate at low levels, slowly weakening the immune system. Untreated or poorly managed HIV during this phase may cause:
- Persistent fatigue
- Low-grade fevers
- Swollen lymph nodes (neck, armpits, groin)
- Unexplained weight loss
- Recurrent yeast infections (oral or vaginal)
- Skin conditions like seborrheic dermatitis or psoriasis
- Prolonged diarrhoea
- Mild neurological symptoms (difficulty concentrating, mood changes)
Advanced HIV Infection (AIDS)
Without treatment, HIV progresses to AIDS, defined by a CD4 count below 200 cells/mm³ or AIDS-defining illnesses. Symptoms are severe and life-threatening, including:
- Chronic diarrhoea lasting over a month
- Persistent high fevers
- Profound weight loss (“HIV wasting syndrome”)
- Generalised lymphadenopathy
- Severe fatigue
- Difficulty breathing or chronic cough (e.g., pneumocystis pneumonia)
- Oral thrush or oesophageal candidiasis
- Neurological issues (memory loss, confusion, seizures)
- Kaposi’s sarcoma (HIV-associated cancer)
- Tuberculosis and other systemic infections
Gender-Specific and Paediatric Symptoms
Women with HIV may experience:
- Frequent vaginal infections
- Pelvic inflammatory disease (PID)
- Menstrual irregularities
- Cervical dysplasia or cancer
Children may show signs such as:
- Failure to thrive or delayed growth
- Recurrent infections (ear infections, pneumonia)
- Developmental delays
- Enlarged spleen or liver
- Neurological difficulties
Early testing is especially critical for children born to HIV-positive mothers.
Importance of Recognising HIV Symptoms
Early recognition leads to prompt testing and treatment, which prevents disease progression and improves quality of life. Due to the variable symptoms and stigma, many people delay diagnosis. Public education and routine screening are vital, especially for high-risk groups.
Symptoms After Starting Treatment
Some individuals on antiretroviral therapy (ART) may experience immune reconstitution inflammatory syndrome (IRIS), a temporary worsening of symptoms caused by immune recovery. Despite this, most people see improved health, reduced symptoms, and increased energy after starting treatment.
Summary
Symptoms of HIV range from mild flu-like signs to severe life-threatening conditions depending on the infection stage and care access. Awareness, early testing, and treatment are essential to prevent progression to AIDS. Reducing stigma and educating communities helps individuals seek care sooner, improving personal and public health outcomes.
